Mechanism Of Psychology, Functional Imageology, And Group Psychological Intervention In Adolescents With Internet Addiction

PartⅠ: Psychological features of adolescents with internet addictionOBJECTIVE: To investigate the prevalence of internet addiction (IA)among adolescents and to explore the psychological features associatedwith internet addiction.METHODS: This study was performed in 2 stages. We screened for thepresence of internet addiction among 2620 high school students (ageranging from 12 years to 18 years) from four high schools of ChangshaCity using Diagnostic Questionnaire for Internet Addiction (YDQ).According to the modified YDQ criteria by Beard & Wolf and structuredclinical interview, 64 students who were diagnosed as IA and 64 normalstudents in internet usage were included in a case control study. The twogroups were assessed using Eysenck Personality Questionnaire (theedition for children, EPQ), Time Management Disposition Scale (TMDS), Strengths and Difficulties Questionnaire (SDQ), ADHD DiagnosticScale-Parent Version(ADHDDS-P), and The screen for child anxietyrelated emotional disorders (SCARED). RESULTS: The rate of internet use among the surveyed adolescents was88%, among which the incidence rate of IA was 2.4%. The IA group hadsignificantly higher scores on the EPQ subscales of neuroticism, psychoticism, and lie than the control group (P＜0.01). The IA groupscored lower than the control group on the TMDS subscales of sense ofcontrol over time, sense of value of time, and sense of time efficacy(P＜0.05～0.01). Compared to the control group, the IA group had alsosignificantly higher scores on the SDQ subscales of emotional symptoms, conduct problems, hyperactivity, total difficulties and lower scores on thesubscale of prosocial behaviors (P＜0.05～0.01). IA group hadsignificantly higher scores on the ADHDDS-P of Inattention factor, Hyperactivity/impulsivity factor than the normal group (P＜0.01). IAgroup had significantly higher scores on the SCARED subscales ofsomatization/panic, general anxiety, social phobia, school phobia, anddissociative anxiety than the control group (P＜0.01).CONCLUSIONS: The present study suggests that internet addiction isnot rare among adolescents. In addition, adolescents with internetaddiction possess different psychological features when compared withthose who use the internet less frequently. PartⅡ: Neuropsychological testing of impulsivity behavior ofadolescents with internet addictionOBJECTIVE: To examine the impulsivity behavioral features ofadolescents with internet addiction and to explore the relationshipbetween impulsivity and internet Addiction.METHODS: This study was performed in 2 stages. We screened for thepresence of internet addiction among 2620 high school students (ageranging from 12 years to 18 years) from four high schools of ChangshaCity using Diagnostic Questionnaire for Internet Addiction (YDQ).According to the modified YDQ criteria by Beard & Wolf and structuredclinical interview (excluding current psychiatric comorbidity), 50students who were diagnosed as internet Addiction (mean age, 14.8 years)and 50 normal students in internet usage (mean age, 14.5 years) wereincluded in a case control study. The two groups were assessed usingBarratt Impulsiveness Scale 11(BIS-11) and behavioral measure ofimpulsivity (GoStop Impulsivity Paradigm).RESULTS: The internet addiction group had significantly higher scoreson the BIS- 11 subscales of Attentional key, Motor key, and Total scoresthan the control group (P＜0.05～0.01). Internet addiction group scoredhigher than the control group on the failure to inhibit responses of GoStopImpulsivity Paradigm (P＜0.01). There was a significant positive correlation between YDQ scores and BIS-11 subscales and the number offailure to inhibit responses of GoStop Impulsivity Paradigm.CONCLUSIONS: This study suggests that adolescents with internetaddiction exhibit more impulsivity than controls which could beassociated with the psychopathology of internet addiction.PartⅢ: Functional magnetic resonance imaging of impulsivity inadolescents with internet addictionOBJECTIVE: To explore the functional areas difference in brain whichmainly associated with impulsivity behavioral features betweenadolescents with internet addiction and health controls by functionalmagnetic resonance imaging (fMRI).METHODS: Nine IA adolescents and eight health control individualswere tested by fMRI when playing GoStop Impulsivity paradigm, thenaveraged these data in two groups and compared activation regions.RESULTS: (1) Functional magnetic resonance imaging showed thatfrontal cortex(superior frontal gyrus, middle frontal gyrus, inferior frontalgyrus), limbic Lobe (cingulate gyrus, parahippocampal gyrus), temporal lobe(superior temporal gyrus, middle temporal gyrus), parietal lobule (inferior parietal lobule, superior parietal lobule, precuneus)and cerebellum mainly participated GoStop Impulsivity task. (2) IAgroup showed bigger activitation range in these regions and more otherbrain activation regions than control group. Compared with control group,IA group showed increased activation in superior frontal gyrus, limbiclobe(BA24,BA31,BA29,BA28,BA35,BA19), temporal lobe(BA42,BA22,BA38,BA13,BA21), inferior parietal lobule, lingual gyrus,cerebellum, midbrain, thalamus, lentiform nucleus, putamen.CONCLUSIONS: There are much neuromechanisms related withmultiplicity impulsivity. Frontal cortex and cingulate gyrus may besignificant role in these neuromechanisms. IA adolescents arehypofunction in these gyri.PartⅣ: Control study of cognitive behavioral group therapy onadolescents with internet addictionOBJECTIVE: To investigate the effect of cognitive behavioral grouptherapy on adolescents with internet addiction (IA).METHODS: A total of 2620 high school students from four high schools of Changsha City were surveyed using Diagnostic Questionnaire forInternet Addiction (YDQ). According to the modified YDQ criteria byBeard & Wolf and structured clinical interview, 64 students werediagnosed as internet addiction. 29 high school students with IA from twohigh schools received group psychological therapy. 35 high schoolstudents with IA from the other two schools were taken as control(control group). All the students in both groups were assessed withDiagnostic Questionnaire for Internet Addiction(YDQ), Chen InternetAddiction Scale(CIAS), The Screen for Child Anxiety Related EmotionalDisorders(SCARED), Strength and Difficulties Questionnaire(SDQ).RESULTS: The scores Of SCARED and SDQ subscale of emotionalsymptoms of experimental group decreased significantly (P＜0.05～0.01)after treatment. The scores Of YDQ and CIAS of experimental groupwas significantly lower than that in control group(P＜0.01) after treatment.The significant improved clinical effect rates and total effect improvedrates of experimental group were 57.69％and 76.92％respectively. Thesignificant improved clinical effect rates and total effect improved ratesof experimental group were significantly higher than that in controlgroup(P＜0.01).CONCLUSIONS: The cognitive behavioral group therapy cansignificantly reduce IA and improve psychological function showing inprofiles of SCARED for the middle school students with IA.